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CSS Insurance

Cost targets and cost containment measures

Per capita healthcare costs continue to rise at rates that by far outstrip the cost of living and wage growth. As a result, an increasing number of insured persons find themselves struggling to pay their monthly premiums. At the same time, many cantons are increasingly withdrawing from the premium reduction system in an attempt to make savings.

That is why CSS Insurance welcomes the discussion launched in 2017 on suitable measures for reining in costs within the mandatory healthcare insurance (OKP) system. It actively supports the implementation of measures from the report produced by the group of experts appointed by the Federal Council to recommend action on the subject as well as the first package of measures proposed by the Federal Council itself on the basis of that report.

Binding targets must be set for OKP growth in order to keep future cost growth in check and make it measurable in qualitative terms. These would serve as benchmarks for all future cost containment measures, thus making the latter both measurable and manageable. In addition, targets of this kind would strengthen the tariff partnership by increasing the pressure on tariff partners to enter into agreements that place greater emphasis on cost-effectiveness, thus reining in cost growth. The tariff partners have failed in their negotiations to bring costs under control, despite repeated statements of intent to the contrary. The current operating conditions and tariffs can do nothing to stem volume growth and therefore cost growth. Binding targets would also force the authorities to fully live up to their responsibility and statutory remit to act in favour of the insured persons when it comes to HTAs or administered prices, for example.

Should these binding cost targets not be met, in spite of the cost containment measures taken, a brake on costs would have to be applied as a subsidiary measure and last resort. There is no doubt that our insured persons will not be able to afford costs if they continue to develop for much longer at current growth rates. CSS welcomes the open and timely discussion on what possible forms these attempts to put a brake on costs could take and is keen to play a constructive role.

You can find further information on the topic of measures to rein in costs on health policies "im dialog" 3/2017 and 3/2018 (in German).